Healthnet Anyone?

[natashad 0]

Hi everybody!

First off, just a quick thanks for all of you who share your answers and thoughts:)

Today, I called healthnet (HMO) and asked if they cover bariatric surgery. Turns out my plan does 80/20. I would have to pay 20% "if I qualify".

A little history. I have been over weight my whole life. In the last 6 years its have been the worst ever. I had 2 kids in the last 5 years and it made things much worse.

I have hypertension ( 5years now) and I think I may have sleep apnea. I am always sleepy. Both of my parents have diabetes, so I know I will if I dont change my life.

Monday the 9th I have my first General DR apt. Where i will tell her that I would like to have the surgery. With my qualifications I believe that I will get an approval from her and the Insurance.

Has anyone gone through Healthnet? If so, what types of evaluations or tests do they put you through. I read that some people have to take weight loss classes for 6 months.

Thanks again

[Chickie55 0]

Yes, I also have Healthnet HMO. I am 55 years old and about 150lbs overweight. My biggest health problem is Hypertension. My legs and feet have been killing me for years, I had knee surgery about 5 years ago. Last November my PCP put me on disability because I could no longer walk around and do my job. He put the request in to my insurance and I swear within a few days I got the approval. My problem was the doctor was so far away. I called Healthnet and found that he was the only doctor contracted with them in SoCal. Since I had no other choice I went to meet with him. After having the pre-tests he wanted done, EKG, Chest X-Ray, Blood work, (Healthnet never asked for any evaluation, it was only the doctors office) I called the doctors office and scheduled my surgery for 3 weeks from then to give me time for the pre-banding diet. I was banded on 4/20 and feel really good, except I am really hungry. I go for my first fill on 5/12. The only thing I had to pay was $150 for things not covered by insurance. As far as I know I am covered 100%.

Boy was I rambling?!! Anyway, I hope I answered some of your questions. Good Luck!!

[natashad 0]

Thank you so so much for your imput and congrats on your journey. I wonder if it will be the same for me.

They also told me that I would need to see a contracted dr. Where I live, I'm sure it will be far too.

I live in Socal as well. I have the HMO silver network. You must have a better plan than I do.

Good luck and thanks again.